Figure 1

Outline of the flaps: Incision was extended posteriorly around the earlobe toward the hairline, behind the ear and then downward 2 cm behind the anterior border of the trapezius muscle. It then transverses the clavicle and deltopectoral groove running parallel to lateral border of pectoralis muscle. The inferior border of the flap runs medially parallel to the clavicle at the fourth intercostals space.